E. Polati et al., PROSPECTIVE RANDOMIZED DOUBLE-BLIND TRIAL OF NEUROLYTIC CELIAC PLEXUSBLOCK IN PATIENTS WITH PANCREATIC-CANCER, British Journal of Surgery, 85(2), 1998, pp. 199-201
Background In a randomized double-blind study the efficacy of neurolyt
ic coeliac plexus block (NCPB) was compared with pharmacological thera
py in the treatment of pain from pancreatic cancer. Methods Twenty-fou
r patients were divided into two groups: 12 patients underwent NCPB (g
roup 1) and 12 were treated with pharmacological therapy (group 2). Im
mediate and long-term efficacy, mean analgesic consumption, mortality
and morbidity were evaluated at follow-up. Statistical analysis was pe
rformed with the unpaired t test, Mann-Whitney U test and Fisher's exa
ct test. Results Immediately after the block, patients in group 1 repo
rted significant pain relief compared with those in group 2 (P < 0.05)
, but long-term results did not differ between the groups. Mean analge
sic consumption was lower in group 1. There were no deaths. Complicati
ons related to NCPB were transient diarrhoea and hypotension (P not si
gnificant between groups). Drug-related adverse effects were constipat
ion (five of 12 patients in group 1 versus 12 of 12 in group 2), nause
a and/or vomiting (four of 12 patients in group 1 versus 12 of 12 in g
roup 2) (P < 0.05), one gastric ulcer and one gluteal abscess in group
2.Conclusion NCPB was associated with a reduction in analgesic drug a
dministration and drug-related adverse effects, representing an effect
ive tool in the treatment of pancreatic cancer pain.